Low-molecular-weight-heparins compared to unfractionated heparin in ST-segment elevation myocardial infarction treated with thrombolysis

Among patients with ST-elevation myocardial infarction (STEMI) treated with thrombolysis, low-molecular-weight heparins (LMWHs), compared to unfractionated heparin (UFH), appear to be associated with a reduction in reinfarction and a trend towards reduced mortality at 30-day follow-up, but with higher risk of major bleeding complications.

A systematic review including 8 studies with a total of 27 758 subjects was abstracted in DARE. Compared to UFH, LMWHs were associated with a trend towards reduced 30-day mortality (OR 0.92, 95% CI 0.84 to1.01) and significant reduction in reinfarction at 30 days (0.65, 95% CI 0.58 to 0.64; NNT 62), but a higher risk of major bleeding complications (2.4% vs 1.8%, OR 1.37, 95% CI 1.16-1.61) in patients with STEMI treated with thrombolysis.

Ədəbiyyat

1. De Luca G, Marino P. Adjunctive benefits from low-molecular-weight heparins as compared to unfractionated heparin among patients with ST-segment elevation myocardial infarction treated with thrombolysis. A meta-analysis of the randomized trials. Am Heart J. 2007;154(6):1085.e1-6